June 10, 2007

New Fee Hits Child Patients: Mary Bridge Clinics Tack on ?Hospital’ Charge

By M. Alexander Otto, The News Tribune, Tacoma, Wash.

Jun. 10--It's gotten more expensive to take a child to a Mary Bridge Children's Hospital outpatient clinic.

On June 1, MultiCare Health Systems, which owns and operates Mary Bridge, started adding a "hospital facility charge" to doctor bills from outpatient clinics, even though most of them are miles away from the hospital.

That means families will be billed as if their child visited the hospital, even if the child never set foot in it.

MultiCare was able to add the charge after it had the clinics classified under federal regulations as providers of "hospital-based services" a few years ago.

MultiCare spokesman Todd Kelley said the classification "reflects the higher level of care" offered at the clinics, which are in Covington, Puyallup, Silverdale, Tacoma and Olympia.

They specialize in treating difficult medical problems, including cancer, sickle cell anemia, and heart, kidney and neurological diseases. The clinics logged 68,000 patient visits in 2006.

The new charges will vary depending on what's done, Kelley said, but in the "vast majority" of visits, they will be between $66 and $77.

Some insurers will cover part of the additional charges, leaving parents or guardians with a co-payment.

Other's won't, Kelley said, so the whole amount will be billed to the child's family or guardian.

The fees won't necessarily pay for any new programs, Kelley said, but will enable MultiCare "to expand the care we offer in the future and better fund the services we currently have."

The new fees could raise several million dollars a year for MultiCare. MultiCare Health System, a nonprofit that also owns and operates Tacoma General, Allenmore and Good Samaritan hospitals, recorded revenues of $642 million in 2004, the most recent figures available.

Regence BlueShield, one of the area's major health insurers, will cover the new hospital facility charge, spokesman Charlie Fleet said Wednesday.

But, he said, "This is news to Regence. We would have liked to have been informed this was happening, given the possible effects on patients."

Pierce County Medical Society president and Lakewood pediatrician Dr. Sumner Schoenike said his group also would have liked a heads-up.

"We were kind of blindsided" by the new charge, he said.

The medical society found out about it last week, when MultiCare mailed thousands of letters regarding the fee to physicians across southwestern Washington.

Schoenike said hospital facility fees used to be limited to care actually provided in a hospital, such as emergency room services.

MultiCare's move signals "a more liberal definition of what is under the hospital umbrella," he said.

Both Fleet and Schoenike said their groups hope to sit down with MultiCare management to find out the reasons for the charge and its implications for patients.

The issue of patients being billed hospital fees for services not provided at a hospital came to national attention last year when Virginia Mason Medical Center in Seattle settled a lawsuit over the issue.

Virginia Mason agreed to refund facility fees to more than 3,200 patients who received outpatient procedures at its downtown Seattle clinics.

Virginia Mason also agreed to begin giving patients estimates of how much their outpatient service would cost.

Skyway resident DeLois Gibson, one of the patients, had a neck blemish removed at a Virginia Mason clinic in downtown Seattle in 2004 and was billed $846 in hospital fees.

She said she was never warned of the fees ahead of time, or told that other outpatient clinics don't charge them.

Aware of that case, MultiCare sent 2,000 letters to patients and their families, alerting them to its new fees.

"We felt it was the prudent thing to do," Kelley said.

Kelley pointed out that, like Virginia Mason, many health systems these days charge hospital fees for services in satellite clinics and that MultiCare has been doing so already at some adult clinics.

Tacoma's other major provider of medical services, the Franciscan Health System, which operates St. Joseph Medical Center in Tacoma and other hospitals, does not add a hospital facility charge to bills at its 36 outpatient clinics in Pierce, King and Kitsap counties, according to spokesman Gale Robinette.

M. Alexander Otto: 253-597-8616

[email protected]


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